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On How To Sneeze Quietly

It'd be more useful to turn up the volume, develop an array of masculine sneezes: http://www.youtube.com/watch?v=gtBRT3Jsrnc

Posted on March 28, 2012 at 6:25 pm 0

On How Much More Does Aspirin Cost Today?

The price comparison is interesting, but the medical review you put together for the intro is not quite right. On the off chance that someone reads the Awl for medical knowledge, for the record:

-- acetaminophen is not an NSAID. ASA and ibuprofen are NSAIDs.

-- ASA is not an anticoagulant (like warfarin or heparin), it's an antithrombotic.

-- acetaminophen can harm the liver, especially when mixed with alcohol. Ibuprofen and ASA do not. NSAIDs can harm kidney function (ASA usually doesn't), but that effect doesn't have anything to do with alcohol. NSAIDs and alcohol in combination will tend to cause gastritis (irritation of the stomach lining), but that would usually develop only with chronic use. So Awl readers are probably safe taking 1-2 Advil at bedtime to mitigate the hangover the morning after.

-- pain is actually not the main reason ASA is so ubiquitous. ASA is the first line medication for secondary prevention of all sorts of vascular disease (coronary artery disease = heart attacks, cerebrovascular disease = strokes, peripheral vascular disease, etc). You link to an article saying that taking ASA has benefits and risks for preventing heart disease. That's true only for people *not known* to have vascular disease. For those with known atherosclerosis (previous stroke, MI, angina, etc), ASA's benefits hugely outweigh its risks in almost all cases. So a huge number of (mostly older) people take a baby aspirin daily. Meanwhile, most chronic and recurring pain (headaches, menstrual cramps, arthritis, back pain) is treated with acetaminophen and ibuprofen under various brand names and formulations.

--It's not even slightly controversial that ASA lowers the risk of heart attacks and other vascular disease, though lowering the risk doesn't mean perfect protection (people can and do have heart attacks while taking ASA). It's just that that benefit is very small in people who have no history and no major risk factors for vascular disease (high blood pressure, cholesterol, diabetes, smoking, age, family history) -- small enough that it's not worth it to have everyone in the world on ASA given that there are downsides like gastritis and stomach ulcers.

-- neuropathic pain is not a "negative sensation". Pain and tingling (paresthesiae) are positive sensory symptoms, as opposed to loss of sensation for touch/temperature/vibration/etc. The point of "neuropathic" modifying pain is that the pain does not reflect local tissue damage (as in nociceptive pain) but comes from abnormal function (often because of damage) of the peripheral nerves themselves.

...sorry to be pedantic.

Posted on January 13, 2012 at 4:21 am 0